Intubation Competence During Neonatal Fellowship Training.

Area of Science:

• Neonatal Medicine
• Medical Education
• Procedural Competency

Background:

• Neonatal intubation is a critical skill for neonatal-perinatal medicine fellows.
• Assessing and ensuring procedural competence is essential for patient safety.

Purpose of the Study:

• To characterize the progression of neonatal-perinatal medicine fellows toward neonatal intubation procedural competence during fellowship training.
• To identify factors influencing intubation success rates.

Main Methods:

• Multi-center cohort study of neonatal intubation encounters (2014-2018) from the National Emergency Airway Registry for Neonates.
• Cumulative sum analysis to assess individual fellow competence (80% success within 2 attempts).
• Multivariable analysis to evaluate the impact of training progression on success.

Main Results:

• 2297 intubations by 92 fellows; 77% success within 2 attempts.
• 45% of assessed fellows achieved procedural competence; 30% exceeded the deficiency threshold.
• Advancing quarter of fellowship training independently associated with increased odds of successful intubation (aOR 1.10).

Conclusions:

• The number of neonatal intubations to achieve competence varies significantly.
• Overall intubation competence rates are modest, suggesting a need for tailored educational strategies.
• An individualized approach to assessing trainee progression is warranted.